Anesthesia Techniques and Monitors

Learning curves of novice anesthesiology residents performing simulated fibreoptic upper airway endoscopy

Dalal PG, Dalal GB, Pott L, et al (Penn State Milton S Hershey Med Ctr, PA) Can J Anesth 58:802-809, 2011^§

Abstract

Background

In various medical and surgical specialties, it is essential to acquire fibreoptic upper airway endoscopy skills for successful endotracheal intubation, especially when faced with a difficult airway. The aim of our study was to evaluate the learning curves of residents performing fibreoptic upper airway endoscopy in the simulation environment.

Methods

Following a standardized video and practice session, 16 residents newly enrolled in the anesthesiology program performed nasal fibreoptic endoscopy of the upper airway (endpoint being the carina) on a high fidelity simulator. Weekly 20-min sessions continued for a period of one month. Each attempt was designated as either a “success” or a “failure” based on the study participant’s ability or inability to visualize the carina in ≤60 sec and with ≤five collisions with the simulated mucosal wall. Proficiency was attained when the downward graphical trend of the cumulative sum (CUSUM) analysis crossed two adjacent boundary lines, i.e., an acceptable failure rate was reached.

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